Utilization Review RN
Schneck Career•Seymour, IN
•Onsite
About The Position
The Utilization Review RN will be responsible for utilization review and medical necessity, concurrent review and length of stay management, retrospective review, payer communication and authorization, and denials management and appeals. This role requires a minimum of 2-3 years of acute care clinical experience and a Licensed RN in the State of Indiana. A BSN is preferred, along with 3-5 years of acute care clinical experience with strong knowledge of medical necessity criteria and payer requirements. Certification plan must be in place within 24 months of hire.
Requirements
- Graduate of accredited school of nursing
- Licensed RN in State of Indiana
- Certification plan in place within 24 months of hire
- 2-3 years of acute care clinical experience
Nice To Haves
- BSN Preferred
- Bachelors Degree in Nursing with case management certification
- 3-5 years of acute care clinical experience with strong knowledge of medical necessity criter and payer requirements
Responsibilities
- Utilization Review and Medical Necessity
- Concurrent Review and Length of Stay Management
- Retrospective Review
- Payer Communication & Authorization
- Denials Management and Appeals
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
